By: Emily Kaufman
In October of 2022, the Florida Board of Medicine voted to draft a rule barring all minors from receiving gender affirming care in the state.[1] This ban is contrary to recommendations by multiple health organizations including the American Medical Association, American Academy of Pediatrics, and the American Psychological Association.[2] The ban stems from a non-binding guidance issued by Florida Governor Ron DeSantis and Florida Surgeon General Joseph Ladapo issued in April of 2022.[3] It is unclear when the ban will take effect, but the implications are dire.[4] One serious ramification is that doctors who prescribe hormones to trans youth could lose their medical licenses.[5] While trans youth who were previously on hormone replacement therapy before the ban will be grandfathered in, children who do not already have this diagnosis will be banned from achieving gender euphoria.[6]
There are valid questions about when the best time is for children to begin taking puberty blockers and hormone replacement therapy.[7] The Mayo Clinic has identified a few potentially long-term side effects of children starting hormone replacement therapy including issues with fertility and bone density.[8]Despite these potentially harmful side effects, Mayo identifies a variety of benefits that can come with children being prescribed puberty blockers including “improved mental well-being, reduced depression and anxiety, improved social interactions and integration with other kids, and [crucially] reduced thoughts or actions related to self-harm.”[9]
Hormone replacement therapy (HRT) and puberty blockers, like all modern medicines, come with side effects and potential complications.[10] In comparison, Viagra[11], can cause low blood pressure, an allergic reaction, sudden vision loss, sudden blindness, heart attack, and stroke.[12] While these side effects are severe, they are not particularly common and as a result there is no public outcry to ban Viagra.[13] Adderall, a common drug to combat ADHD[14], has some potentially extreme side effects including slowed growth in children, blurred vision, seizures, serious heart problems, and sudden death.[15] Likewise, there is no public outcry to ban Adderall in adults or in children, despite potentially deadly side effects.
The dichotomy between the use of drugs such as Viagra and Adderall compared to HRT and puberty blockers for transgender youth, is stark. And the reason for this distinction is simple, transphobia.
In today’s America, transgender people are the convenient punching bag of the far right to stoke fear and rile up the base. Governor Ron DeSantis is using the power of his office to actively harm transgender youth in the state of Florida. Long gone are the conservative days of small government. Republicans like Ron DeSantis are for small government when it suits them, and big government when it means oppressing the powerless. However, Florida is not alone.
Utah[16] and Arkansas[17] have passed similar anti-trans bans while South Dakota[18] just needs the Governor’s signature to pass another trans healthcare ban. In February 2023, legislators in Oklahoma amended HB 2177 to ban all hospitals and clinics that receive public funds from proving any gender affirming care to trans youth or adults.[19] It is the first bill in the nation that would effectively ban gender affirming care for adults throughout the state.[20] Oklahoma’s HB 2177 is meant to drive transgender people out of society, a truly horrifying prospect.[21]
These bans violate the traditional deference that the United States Government has granted to parents concerning personal decisions involving their children.[22] In Pierce v. Society of Little Sisters, the Supreme Court held that an Oregon statute forcing children aged 8-16 to be enrolled in public schools “unreasonably interferes with the liberty of parents and guardians to direct the upbringing and education of children under their control.”[23] The Oregon statute preventing parents from choosing their child’s school unconstitutionally interfered with a parent’s Fourteenth Amendment Due Process rights.[24]Future lawsuits will likely bring up Fourteenth Amendment Due Process claims in response to these anti-trans statutes as these laws and regulations unduly interfere with a parent’s right to control the medical care of their child.[25]
In Arkansas, a trans youth healthcare ban was enacted in April 2021, over the Republican Governor’s veto, who claimed that it was a vast government overreach.[26] Subsequently, a transgender teenager in Arkansas filed suit and a District Court temporarily blocked the ban from taking effect.[27] The Constitutional and ethical implications of transgender healthcare bans will likely lead to similar litigation here in Florida.[28] The rights of transgender youth and adults in Florida is uncertain, but what is abundantly clear is that things are getting worse every day. The State Government of Florida is actively targeting trans people in an effort to push the trans community back into the shadows. Many trans people feel unsafe in Florida and may seek asylum in states more accepting of the trans community. As a trans woman I am deeply concerned, and so should all Americans, especially those living in Florida.
[1] Jo Yurcaba, Florida medical board votes to ban gender-affirming care for transgender minors, NBC News, Oct. 29, 2022, https://www.nbcnews.com/nbc-out/out-news/florida-medical-board-votes-ban-gender-affirming-care-transgender-mino-rcna54632.
[2] Id.
[3] Id.
[4] Romy Ellenbogen, Sam Ogozalek, Florida to ban care for transgender youth — even in clinical trials, Feb. 10, 2023, https://www.tampabay.com/news/health/2023/02/10/transgender-youth-gender-affirming-care-banned-florida-clinical-trials/.
[5] Id.
[6] See, Id.
[7] Pubertal blockers for transgender and gender-diverse youth, Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/in-depth/pubertal-blockers/art-20459075.
[8] Id.
[9] Id.
[10] See, Id.
[11] Viagra is used to combat erectile dysfunction.
[12] Side Effects of Viagra: What You Need to Know, Healthline, https://www.healthline.com/health/drugs/viagra-side-effects#more-common-side-effects.
[13] See, Id.
[14] ADHD is also known as Attention deficit-hyperactivity disorder.
[15] Sarah Lobello Pearson, What Are the Long-Term Effects of Adderall?, GoodRx, Dec. 14, 2021, https://www.goodrx.com/adderall/long-term-effects-of-adderall.
[16] Utah’s new law bans gender affirming care for transgender youth, NPR, Feb. 11, 2023, https://www.npr.org/2023/02/11/1156306026/utahs-new-law-bans-gender-affirming-care-for-transgender-youth.
[17] Natasha Lennard, Right-Wing Appeals Court Blocks Arkansas Ban on Trans Health Care, The Intercept, Aug. 31, 2022, https://theintercept.com/2022/08/31/arkansas-trans-health-care-ban-court-blocked/.
[18] Brooke Migdon, South Dakota poised to ban gender-affirming care for trans youth, The Hill, Feb. 09, 2023, https://thehill.com/homenews/state-watch/3851907-south-dakota-poised-to-ban-gender-affirming-care-for-trans-youth/.
[19] H.R. 2177, 59th Leg., 1st Sess. (Ok. 2023).
[20] Id.
[21] See, Id.
[22] Pierce v. Soc’y of Sisters, 268 U.S. 510 (1925).
[23] Id. at 534-35.
[24] Id.
[25] E.g., Id.
[26] Eliza Fawcett, After Arkansas Trial, Judge Weighs Legality of Ban on Care for Transgender Youth, N.Y. Times, Dec. 04, 2022, https://www.nytimes.com/2022/12/04/us/arkansas-hormone-therapy-transgender.html.
[27] Id.
[28] See, Id.
